Monday, July 30, 2007

I think of myself as an intellectual, scientifically-grounded, skeptic, not at all prone to metaphysical perturbations in my clear, solid, logical, belief system. But then there was the night I channeled Jerry Garcia. It is difficult for a rational mind such as mine to accept, but for a few minutes my actions were not my own: my entire body and being were totally controlled by the spirit of our dear departed Jerry Garcia. I was as surprised as anyone to learn that he’s kind of an asshole.

Saturday, July 28, 2007

I assumed that “Sicko” was going to be an inferior rip-off of the Gus Van Sant classic “Psycho,” and so I was reluctant to see it. I hate it when they remake classic films (e.g.; Poseidon Adventure / Poseidon; Casablanca / Copacabana; Gilligan’s Island / Lost; Butch Cassidy and the Sundance Kid / Brokeback Mountain; Das Boot / Das Boob; Bush Administration / Bush Administration). But everyone said Sicko was good. So I went, and I’m mighty glad I did.

For those not familiar with the “Sicko”, it is a Michael Moore documentary about the miracles of modern medicine. For example (spoiler alert for the rest of this paragraph), early on we meet an 80-yr-old man who, thanks to modern medicine, is still able to work a full day, every day, cleaning up a store. Then we meet some people who’ve had fingers severed, then reattached! Then we meet a couple of grandparents, one of whom has had three heart attacks and the other has had a stroke and, get this, they’re still alive! (Sorry if I may have got a couple of those details off—was it 2 heart attacks or 3?—but those little details aren’t important—it is a Michael Moore movie after all.) You can’t watch the film without a renewed sense of wonder and gratitude for the miracles that modern medicine have bought us. Through most of civilization’s thousands of years few people have survived even one heart attack, or dismemberment, or stroke, or 80th birthday). Later on we learn that even in a place like godless Cuba, with an average income 1/13 that of the good ol’ USA, modern medicine is a marvel of life-saving technology. Same thing in France (France! Who woulda thought!). Everywhere, it seems, we have medical miracles happening every day--everywhere except England where dental care remains a problem.

BTW, Mr. Moore. You did not need to taint an otherwise excellent documentary by belittling the people of other countries and exhibiting such rah rah “we’re number one” US patriotism. OK, so the English have bad teeth; so what! And the French talk funny; so what! OK, maybe those are just for comic effect, but to make the Canadians look so stupid by showing that one of them will cut off all their fingers, while one of us will only cut off two, is just mean and uncalled for!

But “Sicko” is not just a feel-good summer movie about the wonders of modern medicine. Occasionally, if you view between the lines, you’ll see catch hints of a subtle subtext about a potential health insurance problem in this country. If Mr. Moore had spent more movie time on this healthcare payment problem, instead of so much patriotic praise of our best-in-the-world medical miracles, perhaps he could have done some good and come up with a way to solve the problem. But he didn’t. Sigh… So, I guess it’s up to me, again, to solve yet another major healthcare problem in America.

Most people think the answer is easy: simply implement government-funded universal healthcare, as found in other first-world countries. Take England, for example: As Sicko points out, England was able to quickly switch to free social health care at the end of WWII. Their society had been devastated by years of war, depravation, missiles of mass destructions, and mayhem. Being in total disrepair, it was easy to start something anew. Here in the U.S., at this time, we haven’t recently suffered years of a real, hard-fought, devastating war. Just our bad luck, I guess.

We can’t so easily switch because we currently have a semi-working system composed of these components:

Health insurance provided by employers, for well-to-do employees

Health insurance provided by the government, for less affluent

Emergency rooms that don’t turn away critically sick (critically sick because they couldn’t afford to get medical services before they were critical) and ultimately pass on the cost to those in the other two categories

Morgues that accept any kind of riff-raff

OK. It’s not a great system. It’s too expensive. It punishes employers. But the thing is, it exists now, it kinda sorta works, and, most importantly: it employs a lot of people. Moving to a free-healthcare plan would mean that all of those people who now work for insurance companies, work in HR managing insurance plans, or work in doctor’s offices filling out paperwork, would lose their jobs. There is no possible way that politicians are going to vote for any program that puts that many people out of work, no matter how much money it saves in the long run. (For example, take military bases (please), which almost never close no matter how useless their location, or how ancient the war they’re fighting, because closing them would put people out of work.)

To get to a point where we can switch to free healthcare, we have two options:

Suffer some cataclysmic event that destroys society to the point where we can rebuild it anew

Reform healthcare in such a way that nobody loses their job

Our current president is doing his best to solve the problem using the first option, but I prefer the second. We must provide free healthcare without putting any of the people involved in the health insurance process out of work.

It is time again to learn from the lessons of history. By 1933, the people of the United States realized they had erred in affirming the 18th amendment, prohibiting alcohol. It would seem like a simple thing to just repeal the 18th amendment and be done with it. But, no, after years of prohibition entire industries had emerged to employ a huge number of people based on the 18th amendment: smugglers at all levels to bring in contraband, law-enforcement at all levels to fight the smugglers, jailers, judges, speakeasy proprietors, hidden-flask makers, and on and on. Simply repealing prohibition via the 21st amendment would have put all those people out of work, and elected officials would have been in deep doo doo. So the politicians came up with a plan whereby they could make alcohol legal again, and yet all of those same people could keep their jobs: they made other things illegal in place of alcohol (marijuana, barbiturates, cocaine, eventually amphetamines and hallucinogens, and so on).

So, learning from history, the trick now to making healthcare free is to simultaneously come up with a way so that all of the people now involved in healthcare insurance can keep their jobs, or at least jobs nearly identical to what they are now doing.

... phew, everything so far has been easy. Simple, clear, logical, thinking. Now it gets hard… hmmm…. What to do… what to do...

I got it! It may sound a bit convoluted and, dare I say, “stupid” at first (unlike my usually incredibly-clear blog reasonings), but most political solutions to national crises must be convoluted and stupid if they’re going to be accepted, so follow carefully.

First, Congress shall enact a single-payer, universal, everyone-is-free healthcare system, so that no patient will ever again need health insurance.

Simultaneously, Congress will enact a law stating that if any physician should ever cause any harm, whatsoever, to any patient (and “harm” shall be interpreted extremely loosely from here on) then that physician will be sued, disbarred (or however physicians get dissed), and sent to jail. The only out will be if the physician has purchased insurance before interacting with each and every patient.

“First, do no harm” (“primum nil nocere”) is a revered expression of every medical student. “First, do no harm” (FDNH) is hallowed Hippocratic advice. Now let’s make it THE LAW! Let’s make FDNH insurance necessary for any doctor before treating every patient, and on a per-treatment basis.

From minute 1 of the new laws passing, the same people who two minutes earlier had been involved in insurance for every patient to be allowed to see any doctor, will instead be involved in insurance so that every doctor is allowed to see any patient. At every level of the health-insurance chain, everyone will continue to do what they did before, except in reverse.

Yeah, that’s the ticket. Everyone gets free medical care. No one loses their job. We might even be able to employ more people with this scheme. It’s perfect, except maybe for a few physicians who will forget their FDNH insurance and end up in prison. But every prison cell needs someone they call “Doc.” All the classic prison movies have a character named “Doc,” and isn’t recreating classic films what this is all about?

Tuesday, July 10, 2007

The fashion trend this season is layers. When dressing for a Midwest summer, or a summer anywhere that experiences temperatures regularly above 80° F along with high humidity, be sure to bring wool sweaters, coats, ski caps, leggings, and fur-lined gloves. These accessories are necessary because, although it may be 100° outside with 90% humidity, the instant you step indoors the temperature will drop so quickly to the arctic extreme that the sweat on your skin will, if left unprotected, instantly freeze into what Midwesterners call Ice Scabs. Ice Scabs are not as painful as they sound, but if you’re inexperienced with Ice Scabs and try to bend your limbs before they are scraped off, then Ice Scabs will turn into Dermal Ice Fractures, which are as painful as they sound. The trick is to add the layers on each limb as you walk through the door, in one fluid motion—-easy once you get the hang of it.

I learned about summer layering during a recent visit to Lawrence, Kansas. I wondered why they needed to keep buildings so damn cold—why cool would not be enough. Haven’t these people heard of global warming? (Turns out they haven’t—many of them went to see “An Inconvenient Truth” last summer, but because the theaters were so cold they were all wearing earmuffs and so no one heard what Al Gore was saying—with all the graphs on screen they assumed it was a longer, more-boring, live-action version of “Harold and the Purple Crayon.”)

I had idle time to think upon these things when I was in Lawrence, stopped at a railroad crossing, waiting for a long long train to pass. I decided that they—we—keep it so damn cold because we can. We must prove we’re stronger than nature. When it’s night time we must light ever square foot of land with street lights: Darkness is conquered! And when it’s hot we must prove to nature that we can beat her heat.

The train I was waiting on was a coal train, delivering its regular load of coal to the nearby power plant. 143 cars stuffed with coal that will warm the globe so that we can chill every bit of indoor space to temperatures lower than those we bundle up against in the winter. As the last of the 143 cars rolled on by I thought about our collective societal I.Q and wondered: If only we could use our stupidity for good instead of evil.

If only we could use our stupidity for good instead of evil.

Then the train was gone, the railroad crossing gate rose, I pressed on the accelerator, and I stopped thinking.

Summer safety tip: If you’re visiting Walmart this summer, be sure to bring along a thermal reflective emergency blanket in case you get lost in an aisle. You don’t want to end up like this guy.

Tuesday, July 3, 2007

In recent polling the Iraq war appears very unpopular. Those same polls give record low levels of support for our Commander in Chief. Among our test sample, only "Al Qaeda" registered with lower popularity than "President Bush". The term "Insurgents" barely registered on the unpopularity scale.

From this point forward, the opponents in Iraq operations are no longer to be termed "insurgents" but are to be called "Al Qaeda in Iraq". We expect this new war against Al Qaeda to be much more popular than the old war against Insurgents. In all interaction with the press, every opportunity should be taken to use the term "Al Qaeda", and 25% of these should be the full "Al Qaeda in Iraq".

For example, this is an ideal response to a typical reporter’s question:

Reporter: What additional security measures are you putting in place to protect the Green Zone? Does that involve additional troops? And are those additional troops deployed as part of the surge or are they being reassigned from other areas around Baghdad or elsewhere in Iraq?

A special Pysch-Ops team is developing a new label for our enemy, in hopes of discovering a term more unpopular than "Al Qaeda". "Yellow-Green Bile" is showing promise, although testing is incomplete. At your own discretion, you may choose to refer to the enemy as "Yellow-Green Bile" or possibly "Yellow-Green Bile in Iraq", but until we receive more polling data the official enemy is now "Al Qaeda".